Micro Ch 27 Vector borne infections
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| HA, Fever, GI bleed, shock, death. Mid-zonal liver damage with acidophilic inclusion bodies. Dx? | Yellow Fever
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| African teen w/ F, HA, N/V, and rash. Gets better. 4 years later sick w/ rapid deterioration, shock, GI bleed and skin petechial hemorrhage | dengue fever w/ DHF/DSS
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| Fever, HA, rash, Vasculitis in skin, liver, CNS. Usual agent? | Rickettsiae, not Q-fever
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| American child, in July, bit by tick; F, severe HA, myalgia Dx/ what do you expect next? | RMSF; R. rickettsia; maculopapular rash; dog tick
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| October in Greece, F, HA, myalgia, then rash on palms and soles; Dx? Outcome/ | R. conorii; dog tick; favorable
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| Brill-Zinsser disease. Caused by | Epidemic typhus; R. prowazekii
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| Slum in War torn South America, outbreak, no eshar, F, HA, 5 days later body rash spreading out, delirium and coma Dx? | R. prowazekii; Epidemic typhus; body louse
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| Less sever than epidemic typus | Endemic typhus; R. typhi; rat flea
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| Japan, eschar, F, HA x 5 days then macular rash. Dx? Transmitted? | O. tsutsugamushi; chiggers
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| Gram – spirochete, geimsa stain, F/C wax and wain every 5-7 days Dx? Tx? Transmission? | R. recurrentis; Tetracycline; Ticks
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| Erythema Migrans Dx? Tx? 3 latent Sxs? | B. burgdorferi in USA, garinii/afzelii in other parts; Doxy; neurological, cardiovascular, arthritis
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| BAKE a key LYME pie | Bell’s palsy, Arthritis, Kardiac block, Erythema migrans
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| Q fever Cause? | Coxiella burnetti
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| Trench Fever Cause? | Bartonella Quintana
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| Granulocytes with berry cluster of organisms | Erlichia chaffeensis
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| W. Africans lack this, gives resistance to P. vivax | Duffy antigen
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| Most virulent Plasmodium. | falciparum
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| Plasmodium that can cause Nephrotic syndrome | P. malariae
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| Can leave “sleeping” hypnozoites in liver for up to 2 years to cause relapse | P. ovale and P. vivax
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| Plasmodium that can persist at low levels for decades and then cause Sxs from time to time | P. malariae
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| Renal failure due to acute tubular necrosis in a traveler to Africa Dx? | P. falciparum
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| 3 contributors to plasmodium mortality | anemia, hypoglycemia, lactic acidosis
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| East? West? African Sleeping Sickness Causes? | T.b. rhodesiense & T.b. gamiense
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| Sleeping sickness with swollen chancre at site of bite WorE? | East T.b. rhodesiense
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| Winterbottom’s sign, what is it and DDX? | swollen lymph node on back of neck: T.b. rhodesiense or gambiense
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| Sleeping sickness Txs? | Rhodesiense: Suramin(IV) then CNS Melarsoprol; Gambiense: pentamidine/eflornithine then eflornithine/ Melarsoprol.
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| Chagas’ Disease Cause? Transmission? | T.cruzi; “kissing” bug; painless bite
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| Chagas’ Dxtic findings/Sxs? | Chagomas at bite, fever, immediate heart failure; megacolon, megaesophagus; weakening & dilation of the heart ventricles
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| Transmitted by sandfly | leishmania parasites
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| Leishmania infect what cells? | intracellular macrophages
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| Fever, weight loss x months, then hepato-splenomegaly | kala-azar; Visceral leishmaniasis
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| Treated kala-azar can result in | PKDL- post kala-azar dermal meishmaniasis.
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| 3 New World leishmaniasis species | braziliensis, Mexicana, peruviana.
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| Bloody urine Dx? Tx? Visual findings and possibilities? | Schistosomiasis (haematobium) Priziquantel; bladder polyps, inflammation; malignant change
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| Portal hypertension with perisinusoidal granulomas, Symmers’ pipestem fibrosis Dx | Schistosomaisis
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| Swollen scrotum worsening over years, with lower limb involvement Dx? Tx? | Brugeria or Wuchereria; Albendazole
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